WCMS Alumni - Nomination Form

Nominee Information

First Name(*)

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Last Name(*)

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Organization

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Address 1(*)

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Address 2

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City(*)

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State(*)

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Zip(*)

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Phone Number(*)

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Email(*)

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Nominator Information

First Name(*)

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Last Name(*)

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Organization

Please Enter Your Organization

This is a business address

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Address1(*)

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Address 2

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City(*)

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State(*)

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Zip(*)

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Phone Number(*)

Please enter your phone number in the format XXX-XXX-XXXX

Email(*)

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Why should your nominee win the Likens Award?(*)

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What impact has your nominee had on their credit union and/or the credit union industry?(*)

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Prove you're human!(*)

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